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Vermont rates for HCPCS A4375

Ostomy Pouch Drainable With Faceplate Attached Plastic Each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.61 / $16.22 / $16.22
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.93 / $15.93 / $16.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.78 / $13.54 / $13.93
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.93 / $15.93 / $16.41
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.78 / $13.54 / $13.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.30 / $14.60 / $27.75